MR. ROBERT WILLIAM DYCUS (NPI# 1568095453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568095453 |
| Entity Type | Individual |
| Full Name | MR. ROBERT WILLIAM DYCUS |
| Credential | NP-C |
| Practice Address |
130 N. High Street Shubuta MS 39360-3936 |
| Mailing Address |
154 Waller Ridge Rd Shubuta MS 39360-9683 |
| Practice Telephone | 6016871391 |
| Mailing Telephone | 6016789655 |
| Enumeration Date | 2020-02-19 |
| Last Update Date | 2020-10-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
903861 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09333052 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 154 Waller Ridge Rd, Shubuta, MS 393609683 | 6016789655 |
| Street Address |
130 N. HIGH STREET |
| City | SHUBUTA |
| State | MS |
| Zip Code | 39360-3936 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851903264 | Irvin Charles Jackson | Non-emergency Medical Transport (VAN) | 327 East Street, Shubuta, MS 39360 | 2020-08-18 |
| 1053882415 | Debra Eloise Bender | Non-emergency Medical Transport (VAN) | 6320 County Road 610, Shubuta, MS 39360 | 2018-12-11 |
| 1376727388 | Jacquenett Jackson | Custodial Care Facility | 114 Second Street, Shubuta, MS 39360 | 2007-12-27 |
| 1457477481 | Virgie C Wade | Nurse Practitioner | 130 North High St, Shubuta, MS 39360 | 2007-03-21 |
| 1548359565 | Outreach Health Services,inc. | Clinic/Center | 130 North High Street, Shubuta, MS 39360 | 2006-10-11 |
| 1568644383 | Superior Home Care | Early Intervention Provider Agency | 130 County Road 2700, Shubuta, MS 39360-8600 | 2007-12-04 |
| 1881921682 | Superior Home Care | Respite Care | 130 County Road 2700, Shubuta, MS 39360-8600 | 2009-11-16 |
| 1912903766 | Karen Parker | Nurse Practitioner | 130n High St, Shubuta, MS 39360-8870 | 2005-06-27 |
| 1578920328 | Shanika Boyd | Nurse Practitioner | 130 N High St, Shubuta, MS 39360-8870 | 2016-01-25 |
| 1811367048 | Patricia Simpson | Nurse Practitioner | 130 N High St, Shubuta, MS 39360-8870 | 2015-09-30 |
| Find all providers in zip 39360 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457477481 | Virgie C Wade | Nurse Practitioner | 130 North High St, Shubuta, MS 39360 | 2007-03-21 |
| 1174139455 | Jasmine Granger | Nurse Practitioner | 130 S High St, Shubuta, MS 39360-9500 | 2020-09-22 |
| 1992983829 | Chasity Michelle Sisson | Nurse Practitioner | 130 N High St, Shubuta, MS 39360-8870 | 2008-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982205423 | Ronequa Evans | Nurse Practitioner | 811 Clubhouse Dr, Pearl, MS 39208-7023 | 2020-11-02 |
| 1659971380 | Lucy M Barnes | Nurse Practitioner | 2401 State Blvd, Meridian, MS 39307-5033 | 2020-10-30 |
| 1952901076 | Angela Holloway | Nurse Practitioner | 1316 County Road 94, New Albany, MS 38652-8556 | 2020-10-28 |
| 1073113304 | Tasha Rucker | Nurse Practitioner | 2372 Us49-e, Sumner, MS 38957 | 2020-10-27 |
| 1881293371 | Hanna Fernandez | Nurse Practitioner | 14225 Dedeaux Rd, Gulfport, MS 39503-3369 | 2020-10-26 |
| 1285233452 | Darlene Johnson | Nurse Practitioner | 2808 Allyson Gene Cv, Byhalia, MS 38611-7359 | 2020-10-20 |
| 1447857073 | Clarissa Nicole Yarborough | Nurse Practitioner | 113 Saint John Rd, Tylertown, MS 39667-7927 | 2020-10-06 |
| 1922615616 | Jack Chandler Papa | Nurse Practitioner | 3556 May Brook Cv, Southaven, MS 38672-1006 | 2020-09-26 |
| 1205443165 | Mallory Stockstill | Nurse Practitioner | 27 Tillery Pl, Ellisville, MS 39437-4784 | 2020-09-24 |
| 1184230898 | Evelyn Michelle Rainey | Nurse Practitioner | 271 Eskridge Road, Duck Hill, MS 38925 | 2020-09-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.